Healthcare Provider Details

I. General information

NPI: 1679752091
Provider Name (Legal Business Name): DR. SHAMIKA PRYOR BROOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAMIKA SHARNELL PRYOR

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20032-2608
US

IV. Provider business mailing address

204 MACARTHUR RD
ALEXANDRIA VA
22305-1847
US

V. Phone/Fax

Practice location:
  • Phone: 202-372-4126
  • Fax:
Mailing address:
  • Phone: 240-351-2747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number19691
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: